Volume 43 Number 3, May/June 2006
Pages 311 — 322
Abstract - Does motor lateralization have implications for stroke rehabilitation?
Robert L. Sainburg, PhD, MS, OTR;1-3* Susan V. Duff, OTR/L, PT, EdD1
Departments of 1Kinesiology, 2Neuroscience, and 3Bioengineering, The Pennsylvania State University, University Park, PA
Abstract — Recent findings on motor lateralization have revealed consistent differences in the control strategies of the dominant and nondominant hemisphere/limb systems that could have implications for hemiplegic stroke patients. Studies in stroke patients have demonstrated deficiencies in the ipsilesional arm that reflect these distinctions; patients with right-hemisphere damage tend to show deficits in positional accuracy, and patients with left-hemisphere damage show deficits in trajectory control. Such deficits have been shown to impede functional performance; yet patients with severe dominant-side hemiplegia must often use the nondominant arm as the primary manipulator for activities of daily living. Nevertheless, the nondominant arm may not spontaneously become efficient as a dominant manipulator, as indicated by the persistence of deficits in chronic stroke patients. More research is necessary to determine whether motor therapy can facilitate a more effective transition of this arm from a nondominant to a dominant controller.
Key words: coordination, dynamic dominance, handedness, hemiplegia, ipsilesional deficits, lateralization, motor control, motor learning, rehabilitation, stroke.